Sister Mary Joseph's nodule.

A 51-year-old man was referred to the dermatology department for a painful lesion on the abdominal wall that had appeared 1 year before as a slow-growing, inconspicuous papule. The patient was otherwise asymptomatic. On examination, he had a hard erythematous nodule on the umbilical region, measuring 35 × 25 mm, with central crusting (Fig. 1) and a palpable deep component whose limits exceeded those of the superficial lesion. Skin biopsy revealed an adenocarcinoma with intestinal-type immunohistochemical profile. Exploratory laparotomy revealed large and diffuse peritoneal implants and a petrous gallbladder suggestive of a primary neoformation. The patient died 6 weeks after diagnosis due to the tumor progression.

Figure 1

A solitary erythematous nodule with central crusting and irregular borders on the umbilical region.

Sister Mary Joseph’s nodule is a palpable nodular lesion of the umbilical region resulting from an abdominal or pelvic malignant neoplasm [1]. It is usually associated with an advanced stage tumor, with peritoneal metastases and a poor clinical prognosis [2].